In our Phase 1 grant, we demonstrated the feasibility of a virtual reality cue reactivity system (VRCR) for alcohol assessment by producing virtual reality environments (VRE's) that increased subjective craving for alcohol on average 450%, in a sample of 40 abusing and/or dependent adult participants. This Phase II study incorporates VR cue exposure/reactivity into a relapse prevention based treatment. Virtual reality relapse prevention (VRRP) environments will combine computer generated video images depicting drinking cues (e.g. alcoholic beverages, liquor bottles, beer) and drinking related social interactions (e.g. being offered a drink in a social setting, walking around a convenience/gas station that sells beer, interacting with a waiter at a bar/restaurant) presented in contexts that are congruent with real world experiences. A recent development will allow the incorporation of scent cues (e.g. beer, wine, liquor, food, cigarette smoke) into the VR environments. The feasibility of VRRP will be tested in an outpatient clinical treatment trial with alcohol dependent drinkers. Sixty alcohol dependent adults will be recruited and randomized to either VRRP or traditional relapse prevention (TRP). A twelve week treatment trial will compare VRRP vs. TRP on alcohol use, breath alcohol levels, and abstinence rates across treatment and follow-up periods (one, three, and six months). In addition, all participants will be assessed for cue reactivity (craving and physiological) at baseline, week six, and week twelve using a VR cue reactivity assessment environment. The overarching aim of this project is to develop and test VRRP, and develop affordable turnkey, VRRP system that will be commercially available to substance abuse programs, individual therapists, and alcohol researchers for alcohol and other drugs of abuse. We proposed to develop in Phase II, a virtual reality relapse prevention (VRRP) treatment system for alcohol dependence. VRRP will combine computer graphics with sensory input devices including: tracking devices, visual head mounted displays (HMD), scents and directional audio to immerse participants in a computer-generated virtual environment. A controlled clinical treatment study comparing VRRP to traditional relapse prevention will be conducted. [unreadable] [unreadable] [unreadable] [unreadable]